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CHAPTER ONE

INTRODUCTION

1.1   Background of the Study

Malnutrition is estimated to contribute to more than one third of all child deaths, although it is rarely listed as the direct cause. Childhood malnutrition is a serious challenge in Sub-Saharan Africa and a major underlying cause of death. It is a result of dynamic and complex interaction between political, social, economic, environmental and other factors. Malnutri-tion is a major contributor to mortality and is increasingly recognized as a cause of potential-ly lifelong functional disability. Malnutrition is well recognized as a widespread health prob-lem with consequences that are acute and even, more often long-term problems. Malnutri-tion remains a problem of public health concern in most developing countries (Kennedy, Ped-ro, Seghieri, Nantel & Brouwer 2007). Containing less or no animal products, and slight amounts of fresh fruits and vegetables, diets are deficient in micronutrients and of poor qual-ity.

In a global context, approximately 45% of the 6.6 million deaths of children under-five year of age in 2012 are caused by undernutrition (UNICEF, 2012). Geographically, the majority of the undernutrition burden exists in Sub-Saharan Africa and South-Central Asia (Bhutta and Salam 2012). Malnutrition has three commonly used comprehensive types named stunting, wasting and underweight: measured by height for age, weight for height and weight for age indexes respectively. Adequate nutrition continues to play an important role during the school age years in assuring that children reach their full potential for growth, development and health. Nutrition problems can still occur during this age, such as iron-deficiency anemia, under nu-trition such as Kwashiorkor, marasmus, overnutrition and dental caries. The prevalence of obesity is increasing but the beginning of eating disorders can also be detected in some school age and preadolescent children.

In addition, adequate nutrition prevents the onset of health-related problems, encouraging a healthy eating pattern can help prevent immediate health concerns as well as promote a healthy lifestyle, which in turn may reduce the risk of the child developing a chronic condi-tion such as obesity, type 2 diabetes and cardiovascular disease later in life (Story, Holts & Sofka 2000). Adequate nutrition, especially eating breakfast has been associated with im-proved academic performance in school and reduced tardiness and absence (Meyer, Sampson, Weitzman, Rogers & Kayne 1989). Consequently, this meets the energy and nutrient needs of the children, addressing common nutrition problems, and preventing nutrition-related disor-ders.

The growth and development of school-age and preadolescent children and their relationships to nutritional status is significant right from the beginning. Children continue to grow physi-cally at a steady rate during this period; nevertheless the development from cognitive, emo-tional and social standpoint is tremendous. This period in a child's life is preparation for the physical and emotional demands of the adolescent growth spurt, with aid of family members, teachers and others in their lives who model healthy eating and physical activity behaviors.

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